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HomeMy WebLinkAboutTemporary Relocation of Building 2002 Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville,CT 06382 860-848-3030, Ext. 82 Building Permit Permit Number: B2002-599 Permit Date: 16-Oct-02 Permit Code R4 Job Location: 38 PEQUOT ROAD UNIT: MAP/LOT: 072/035-000 Job Description: temporary storage of building Owner Contractor DAVID WADDINGTON David Waddington 33 Pequot Road 33 PEQUOT ROAD Unit: Uncasville,Ct. 06382 UNCASVILLE CT 06382 Telephone: 848-1692 Lic/Reg Type: Use Group R4 Lic/Reg Number: 0 Code 1995 CABO Exp Date: Construction Type 5B Construction Values Permit Fees Building Value: $500.00 Building Fee: $10.00 Plumbing Value: $0.00 Plumbing Fee: $0.00 Mechanical Value: $0.00 Mechanical Fee: $0.00 Electrical Value: $0.00 Electrical Fee: $0.00 Other Value: $0.00 Other Fee: $0.00 Total Value: $500.00 C/O Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.08 Total Fees: $10.08 it is the owners responsibility to schedule the following required inspections jminimum 48 hours notice requested; ❑ Footing-Prior to pouring concrete ❑ Rough HVAC ❑ Backfill-Footing drains and waterproofing ❑ Fireplace Throat ❑ Concrete Slab-Prior to pouring ❑ Fireplace Final ❑ Rough Framing ❑ Chimney-One flue above thimble ❑ Rough Electrical ❑ Firestopping/draftstopping ❑ Electrical Service ❑ Insulation ❑ Rough Plumbing and Leak Test Final Inspection ❑ Gas Piping and Pressure Test /I Certifi . S cup:n.• - Prior to use or occupancy Building Official's Signature: /� Town of Montville Building l;)epartment Permit# 310 Norwich-New London Tpke. Tel. 848-3030,Ext 82 Uncasville, CT 06382 Fax. 848-7231 One &Two Family Building Permit Application Form ❑Vw Construction El Addition []alteration []accessory Structure Other Job Location J LID Y ' l 1 Job Description/Materials ��Z/ f/D1'5( G 7 Owner 4,12- 2,111/C4*')51/z%lc Mailing Address City X110 1if'G State Zip 06 16P2.Tel IP6''/?Ifa / /‘.5)2 Contractor L9 Mailing Address City State Zip Tel / / Contractor's License/Registration Type &Number Exp. Date / / I hereby certify that the proposed work will ,onform '• t e Basic Building Code and all other codes as adopted by the State of Connecticut and the Town of Montvill- and • .'test that the proposed work is authorized by the owner in fee and that I am authorized to make application fc a • • Isuch work as described above. 0" Owner/Agent Signature // Date j / / / 0Z Construction Value Fee Building $ E6 c $ /6----- Plumbing $ $ Mechanical $ $ Electrical $ $ Other $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ -o V" Total $ -6©o STATE OF CONNECTICUT WORKERS'COMPENSATION COMMISSION Buildin: Permit Affidavit for Pro.e ' Owners or Sole Pro.rectors (Conn. Gen. Stat. §31-286b) Property located at In the town of Name of building permit applicant: Please check one: 1. I am the owner of the above property. 2. I am the sole proprietor of a business. -2A.Name of business 2B.Federal Employer Identification Number(FFA Pursuant.. §31-286b,«a................................................................... property owner or soleproprietor -------n------... contractor or principal employer"may [who]intends to act as a genera' insurance or a principal notarized provide either a certificate of workers'compensation affidavit... stating that he will proof of workers' �ti� compensation insurance for all those employed on the job site in accordance with this chapter." Please check one: 1. I do not intend to act as a general contractor or principal employer. [Sign and stop here] Signature of applicant 2. I intend to act as a general contractor orane re provide a certificate of workers'compensation P �employer.Applicant must either below. insurance or sign the affidavit ............... Affidavit ....................... I hereby swear and attest that I will uire of worIc contractor,subcontractor,or other worker bcfor°ef he/she end compensation insurance for every accordance with the Workers'Compensation Act gages in work on the above property in (Chapter 568). I understand that pursuantto§31-275 C.G.S.,officers of a partnership may elect to be excluded from coverageO°rPoration and partners in a District Office;and that a sole by filing a waiver with the approp to files his intent to a t proprietor of a business is not required to have coverage he �P coverage. Signature of-ail Subscribed and sworn to before n e this day of 200_ (Notary Public/Commissioner of the Superior Court) Town of Montville Building,Department 848-3030,Ext 82 ONE&TWO FAMILY CONSTRUCTION PERMIT SIGN-OFF SHEET Property Address Job Description: 1-0 P. /oc O/- 1.-711 vfg The owner/agent shall be responsible for the completion of the form, no certificate of occupancy will be issued until all signatures below have been obtained. HEALTH DISTRICT 848-3030-882 Approved ❑ Permit#: Not Applicable Septic System Date Approved ❑ Permit#: 41 Not Applicable Private Well Date WPCA DEPARTMENT 848-3030,Ext.881 Approved ❑ Permit#: Not Applicable Municipal Sewer Date House Trap ❑ Outside ❑ Inside Approved ❑ Permit# Not Applicable Municipal Water Date DEPARTMENT OF PUBLIC WORKS 848-7473 Approved 0 Permit#: •► Not Applicable Director Date PLANNING : ONING DEP: 'TMENT 848-3030.Ext.81 In-Compliance /ae r Zo'C!7 .❑ Permit#: ❑ Not Applicable mg Date In-Compliance r Zoo Z El Permit#: t Applicable Inland-Wetlands Date *visa Town of Montville Building Department Receipt ,. Date __ _/ No. 02225 From: ------ ---------- i - ----- Job Address: Z ��rGz�o7. lzl 404) Amount $ —__/O . O Cas Check Check # (circle one) — Received by , _ �r-v--- t".te.) Permit # Zee7 --5�9 t t Town of Montville Building Department Receipt Date Jo / 0 / o c._.- No. 02226 From: Job Address: 2T TZT-te:rts 79 i C Amount $ 2 • yv Case Check Check # (circle one) Received by 1 . 'uh–r-•-sas Permit #3Zcv2—E00 08/28 '02 14:22 ID:LAN I ERFAX3800 FAX: PAGE 1 %f Light Power% .. .fin +ext•a r" 7 63R Myeoek Avenue Wetertard,CT'06385 The Northeast Utilities System /4! )1?; )-3°641".-- To: �'y �: { l :r`trt � 'F ,�6) 44- Re: R uest for ' pvai sf E ms'#Ce p ? - .f In Arsp©rar cequesrwe receivedt earn: D.44z./ 211 The electric service to: �e ,/� l� was yemoy 4 on: lr`Lr -- 7 ti rano Cristofaro New Service Supervisor 09.5677{Iry 347